三维适形放疗联合替莫唑胺化疗对术后脑胶质瘤的疗效观察  

Observation on clinical efficacies of the combined postoperative application of three-dimensional conformal radiotherapy and temozolomide chemotherapy for brain gliomas

作　　者：张罗生 刘智良[2] 高兴旺 魏丽霞 郭雪霏 闵娜 贾彦征 廖洪 

机构地区：[1]解放军第四五八中心医院肿瘤科,广州510662 [2]中山大学临床医学博士后流动站,广州空军总医院神经外科510275

出　　处：《中华神经医学杂志》2007年第10期1005-1007,共3页Chinese Journal of Neuromedicine

摘　　要：目的分析比较三维适形放疗联合替莫唑胺化疗和单纯放疗对脑胶质瘤部分切除术后患者的疗效和安全性。方法选取自2003年10月至2006年6月42例脑胶质瘤部分切除术后患者,随机分为2组:单纯放疗组(19例)仅行三维适形放疗,分次局部照射,2.0 Gy/次,1次/d,5 d/周,共持续6周,总剂量60 Gy;联合治疗组(23例)于三维适形放疗同时联合替莫唑胺化疗6周+辅助化疗6疗程。影像学动态观察患者肿瘤体积的变化及Kamofsky评分评价神经功能状态。结果放疗结束24周后,联合治疗组在影像学所示肿瘤实体的缩小和神经功能状态(日常生活能力)的改善方面均优于单纯放疗组(P<0.05)。结论放疗联合替莫唑胺化疗可提高脑胶质瘤部分切除术后肿瘤缓解率和患者生活质量。Objective To compare the efficacy and safety of the therapeutic alliance of three-dimensional conformal radiotherapy （3D-CRT） and temozolomide （TMZ） chemotherapy with 3D-CRT alone after partial resection of brain gliomas. Methods Forty-two cases that were hospitalized during Oct., 2003 and Jun, 2006 and performed on with partial resection of brain gliomas were randomly divided into two groups. In the sole radiotherapy group （n= 19）, patients were only treated with 3D-CRT, fractionated focal irradiation in daily fractions of 2 Gy given 5 days per week for 6 weeks, for a total dose of 60 Gy. In the therapeutic alliance group （n=23）, patients underwent the aforementioned 3D-CRT plus continuous daily TMZ chemotherapy for 6 weeks, followed by six course of adjuvant TMZ chemotherapy. Meanwhile, enhanced CT or GD-MRI was performed to evaluate the changes in glioma volume and the nerve function status was evaluated with Karnofsky scale. Results Twenty-four weeks later after radiotherapy, improvements in glioma size and nerve function status （activities of daily living） of the therapeutic alliance group were superior to that in the sole radiotherapy group （P〈0.05）. Conclusion Radiotherapy combined with TMZ can increase the glioma remission rate after partial resection and the life quality of patients.

关 键 词：神经胶质瘤 放射治疗 化学疗法 

分 类 号：R739.4[医药卫生—肿瘤]